| NPI | 1104331396 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: VA 0024175686) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner Family (Licence: VA 0024175685) |
| Enumeration Date | 2017-12-10 |
| Last Update Date | 2020-03-17 |